Imaging Arthritis

Question 1

Degenerative arthritis findings on x-ray

Answer 1

Sub-chondral sclerosis
Osteophyte formation
Sub-chondral cysts
Non-uniform joint space narrowing
= Bone productive

Question 2

Inflammatory arthritis findings on x-ray

Answer 2

Bone erosion (initially marginal)
Soft-tissue swelling
Uniform joint space narrowing
= Bone destructive

Question 3

Why do you get varus knees in OA?

Answer 3

Because the medial component is more narrowed (more weight bearing so collapses first)

Question 4

3 seropositive inflammatory arthritises

Answer 4

RA
SLE
Scleroderma

Question 5

Rheumatoid arthritis

Answer 5

Chronic, symmetric, erosive synovitis
Hallmark: pannus (hypertrophied synovial membrane)
Later change is pencil in cup deformity
Uniform cartilage thinning

Question 6

Psoriatic arthritis

Answer 6

10% of people with psoriasis
Typically involves hands and feet
Erosive features (similar to RA findings)
Productive features

Question 7

Ankylosing spondylitis

Answer 7

Chronic inflammatory arthritis involving sacroiliac joints and vertebrae
Can get syndesmophytes = bony growth within a ligament

Question 8

Gout

Answer 8

Chronic, tophaceous gout

Punched out lytic lesions, overhanging sclerotic margins, tophi in surrounding soft tissues

Question 9

Septic arthritis

Answer 9

Microbial invasion of joint leading to inflammation and purulence
Presents with monoarthritis, pain, swelling, erythema, and restricted ROM
Recognize early or else can get extensive joint destruction